KELLY BUTLER (NPI# 1801179882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801179882 |
| Entity Type | Individual |
| Full Name | KELLY BUTLER |
| Practice Address |
5830 N Clinton St Fort Wayne IN 46825-5734 |
| Practice Telephone | 2604832191 |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2011-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 26016195A | IN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720445018 | Kelly Butler | Physical Therapist | 319 Runnymede Ave, Jenkintown, PA 19046-2022 | 2016-01-18 |
| 1568750271 | Kelly Brooke Butler | Occupational Therapy Assistant | 3940 Lee Jackson Hwy, Greenville, VA 24440-1705 | 2011-07-14 |
| 1699953885 | Kelly Lynn Butler | Counselor | 307 Congress St, Portland, ME 04101-3638 | 2008-02-10 |
| 1639119969 | Kelly Ann Butler | Dentist | 11517 Pacific Ave S, Tacoma, WA 98444-5535 | 2006-06-07 |
| 1427669092 | Kelly Lee Butler | Behavior Technician | 3070 Riverside Dr Ste 200, Columbus, OH 43221-2547 | 2020-08-16 |
| 1538565718 | Kelly Butler | Specialist/Technologist | 1150 Campo Sano Ave, Suite 200, Coral Gables, FL 33146-1174 | 2014-11-14 |
| 1386916120 | Kelly Jean Butler | Physician Assistant | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2012-02-08 |
| 1366744971 | Kelly Dione Butler | Case Manager/Care Coordinator | 3621 N Kelley Ave Ste 100, Oklahoma City, OK 73111-4520 | 2010-12-02 |
| 1164623534 | Kelly A Butler | Pharmacist | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2007-05-31 |
| 1538160650 | Kelly Ann Butler | Nurse Practitioner | 179 River St, Oneonta, NY 13820-2239 | 2005-08-10 |
| Street Address |
5830 N CLINTON ST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-5734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568477677 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5830 N Clinton St, Fort Wayne, IN 46825-5734 | 2006-07-29 |
| 1871901512 | Megan Duvall | Pharmacist | 5830 N Clinton St, Fort Wayne, IN 46825-5734 | 2014-07-25 |
| 1063795235 | Jennifer Lynn Zimmerman | Pharmacist | 5830 N Clinton St, Fort Wayne, IN 46825-5734 | 2011-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1528677622 | Leslie Renee Siegel | Pharmacist | 11109 Parkview Plaza Dr # 1, Fort Wayne, IN 46845-1701 | 2020-07-24 |
| 1962048140 | Andrew Quang Tran | Pharmacist | 6202 Saint Joe Center Rd, Fort Wayne, IN 46835-2506 | 2019-11-21 |
| 1467005991 | Nicholas Selby | Pharmacist | 6220 Saint Joe Center Rd, Fort Wayne, IN 46835-2506 | 2019-07-23 |
| 1215427042 | Jerry Eugene Falls | Pharmacist | 9817 Chapmans Blvd, Fort Wayne, IN 46835-9194 | 2018-05-17 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1063900611 | Juliette Peters | Pharmacist | 1900 Carew St Ste 4, Fort Wayne, IN 46805-4765 | 2018-04-30 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1790238350 | Karleen Goodwin | Pharmacist | 3964 New Vision Dr, Fort Wayne, IN 46845-1712 | 2016-08-01 |
| 1699131300 | Brent Alan Losier | Pharmacist | 3537 N Anthony Blvd, Suite A, Fort Wayne, IN 46805-1423 | 2016-01-11 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on KELLY BUTLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.